MEDICARE: DR. JAMES ANDREW CLYNE D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	H88284	MD
2	207R00000X	Internal Medicine Physician	OS017019	PA

General Provider Information

NPI Number	:	1952697047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES ANDREW CLYNE D.O.

Provider Business Mailing Address
First Line	:	9910 FRANKLIN SQUARE DR # 2110
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21236-4902
Country	:	US
Telephone Number	:	215-255-7822
Fax Number	:	215-255-7825

Provider Business Practice Location Address
First Line	:	137 MITCHELLS CHANCE RD STE 180
Second Line	:
City	:	EDGEWATER
State	:	MD
Zip	:	21037-2793
Country	:	US
Telephone Number	:	410-224-8220
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2011
Last Update Date	:	10/17/2019

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